Cryotherapy Methods to Treat Laminitis

More elaborate approaches to cryotherapy include the Game Ready cooling and compression system, which the presenters considered a superior method to standard icing and ice boots.

Photo: Courtesy Game Ready

Cryotherapy, or cold therapy, has been shown to prevent laminitis in the at-risk equine patient and is often recommended for relieving pain and inflammation in the acutelylaminitic horse. In a workshop at the 6th International Equine Conference on Laminitis and Diseases of the Foot, held Oct. 28-31 in West Palm Beach, Fla., three laminitis researchers discussed commonly used cryotherapy methods.

Presenters included Christopher Pollitt, BVSc, PhD, director of the Australian Equine Laminitis Research Unit and honorary professor of equine medicine at the University of Queensland's School of Veterinary Science; Andrew van Eps, BVSc, PhD, MACVSc, and Dipl. ACVIM, senior lecturer in equine medicine at the University of Queensland's School of Veterinary Science; and James Orsini, DVM, Dipl. ACVS, associate professor of surgery at the University of Pennsylvania's New Bolton Center, all of whom have studied and practiced cryotherapy.

Cryotherapy is known to have anti-inflammatory effects, along with analgesia (pain relief), vasoconstriction (narrowing of the blood vessels), and hypometabolism (which reduces the metabolic demands of the foot or, as Orsini explained it, "puts the foot into a temporary state of hibernation"). The therapy's key mechanism is that it reduces enzymatic activity in the lamellar tissue by about 50% for every 10°C drop in tissue temperature. Benefits of this include:

Decreased pain and muscle spasm (a local anesthetic effect);

Reduced edema (fluid swelling) due to increased blood viscosity and enhanced coagulation; and

Reduced metabolic needs of the lamellar tissue and enzymatic action.

Some cryotherapy methods are more labor-intensive or cost-prohibitive than others. Basic methods include icing and bandaging; applying an ice sleeve, ice pack wrap, or ice boot; or even tethering a horse in a pool of cold water for an extended period of time. More elaborate approaches include the Game Ready cooling and compression system--which the presenters considered a superior method to standard icing and ice boots; the Australian ice tub, which circulates ice water around horses' limbs; and the Equine Spa, which has a built-in refrigerator unit and pump for circulating chilled water. Ideally, van Eps said he would like to see product manufacturers develop a swivel apparatus attached to ice boots that allows a horse to move around his stall while undergoing therapy.

Van Eps also noted that he prefers most horses to remain with their legs immersed in ice water for five to seven days. Interestingly, none of the researchers had documented any negative effects to the horses' hoof integrity due to prolonged submersion in water. However, potential adverse effects of this approach include:

Coagulation (more prone to blood clotting with certain diseases);

Enhanced edema, possibly due to standing in one place for days;

Immunosuppression (reduced disease-fighting ability) believed to be associated with a decrease in white blood cells reaching the tissues of the foot; and

Altered mechanical properties of the tissue thought to be due to the temperature changes (and, thus, reduced flexibility) of the tissues.

The researchers noted that the range of suitable cryotherapy methods is limited only by one's imagination, but that veterinarians and owners should remember cryotherapy's positive effects stem from the circulating action of the ice water. Such benefits cannot be achieved by simply standing a horse in a cold environment or material such as snow.

About the Author

Alexandra Beckstett, Managing Editor of The Horse and a native of Houston, Texas, is a lifelong horse owner who has shown successfully on the national hunter/jumper circuit and dabbled in hunter breeding. After graduating from Duke University, she joined Blood-Horse Publications as Assistant Editor of its book division, Eclipse Press, before joining The Horse.

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